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RICHARD NICHOLAS FORMICA MD
NPI 1730163502
Internal Medicine - Nephrology in New Haven, CT

Active since December 05, 2005PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
800 HOWARD AVE, YALE PHYSICIANS BUILDING, NEW HAVEN, CT 06519(203) 785-2140(203) 785-6414 Get Directions Write a Review

NPPES record last updated: March 22, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Richard Nicholas Formica Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICHARD NICHOLAS FORMICA MD (NPI 1730163502) is an individual nephrology provider in New Haven, Connecticut, licensed in Connecticut (036848) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS and is a graduate of Boston University School Of Medicine (1993).

NPPES Registry Identity

NPI1730163502
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameRICHARD NICHOLAS FORMICACredential: MD
Location Address800 HOWARD AVE, YALE PHYSICIANS BUILDINGNew Haven, CT 06519
Mailing AddressPo Box 9805, 300 George St 6th FloorNew Haven, CT 06536-0805 · (203) 785-7998 · Fax (203) 785-6414
Phone(203) 785-2140
Fax(203) 785-6414
Sole ProprietorNo
Medical School CMSBoston University School Of MedicineGraduated 1993
Enumeration DateDecember 5, 2005
Last NPPES UpdateMarch 22, 2012
✔ NPI 1730163502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in CT · 036848
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedHospitalistTaxonomy 208M00000X · License 036848 (CT)
800 HOWARD AVE, New Haven, CT 06519
Open in Google Maps ↗

Other Identifiers 3

Medicaid001368481CT
Medicare UPING84089
Medicare ID-Type Unspecified110007869CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Richard Nicholas Formica Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507870797
PECOS Enrollment IDI20060126000550
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
210 services125 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
178 services53 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
62 services46 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
42 services38 patients
Needle biopsy of kidney 50200
A needle biopsy of the kidney is a medical procedure where a small sample of kidney tissue is removed using a special needle. This is done to examine the tissue under a microscope for any abnormalities. It helps in diagnosing potential kidney conditions.
20 services19 patients
Ultrasonic guidance for needle placement 76942
Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
18 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Referred Medical Equipment & Supplies CMS DME claims 11

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Azathioprine, oral, 50 mg J7500
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers49 claims2,490 services$4.13 avg. paid by Medicare
Cyclosporine, oral, 100 mg J7502
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers18 claims720 services$1.71 avg. paid by Medicare
Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
10 suppliers397 claims164,172 services$1.20 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
19 suppliers210 claims28,605 services$0.30 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
18 suppliers504 claims77,385 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
5 suppliers30 claims3,660 services$0.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. PAULA M. TORTORICI-SCHEFF FNP
Nurse Practitioner (Family)
800 HOWARD AVE
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 688-4242
GERARD ANDREW BETRO MD
Surgery
800 HOWARD AVE, YALE PHYSICIANS BLDG
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2140
ALEXA BLOOD APRN
Nurse Practitioner
800 HOWARD AVE
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2565
MICHAEL DIGIOVANNA MD
Internal Medicine (Medical Oncology)
800 HOWARD AVE, YALE PHYSICIANS BUILDING - 2ND FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 688-4191
HELENA TERESA CHMIELOWICZ APRN
Clinical Nurse Specialist (Gerontology)
800 HOWARD AVE
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2140
DR. MARC LEWIS ROSEN MD
Physical Medicine & Rehabilitation
800 HOWARD AVE
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2579
MICHELE ANNE GOYETTE -EWING PHD
Psychologist (Clinical Child & Adolescent)
800 HOWARD AVE, YALE PHYSICIANS BLDG
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2140
UZMA USMAN MD
Psychiatry & Neurology (Neuromuscular Medicine)
800 HOWARD AVE
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (999) 999-9999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Formica's NPI number?

The NPI number for Richard Formica is 1730163502. It was assigned to this individual provider in the NPPES registry on December 5, 2005.

Where is Richard Formica located?

Richard Formica practices at 800 Howard Ave Yale Physicians Building, New Haven, CT 06519. The listed phone number is (203) 785-2140.

What is Richard Formica's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Richard Formica enrolled in Medicare?

Yes. Richard Formica is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Richard Formica was last updated on March 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.